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" 152234
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. (Rev. t0/66) 3TATE OF FL:4IiIDA
FLORIDA INDUSTRIAL COMNIISSION
TAI.LA$A33EE Account No._ 079453-B
NOTICE OF TAX LIEN Lien No I-.
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JSOPARDY -
Pursuant to xhe proviaiona of Section 443.1b (8) (a . Florlda Statutes. known aa the Florida Un-
employment Compenaation law. notice ia hereby glven that there have been aseesaed. purauant to the
provisions oi said law. againat
ioo4 srn~th 4th street t~8 ~t ~r~as 33~~
an "employer" liable for the psyment oi contributiona to the Unemployment Compensation F~nd of
Florida, purauant to the proviaiona oi asid l~w. the aum of ~18.47 covering the following
rnntributiona, intereat and penalties, which siter demaad for payment thereof remain unpedd, and
that by virtue of the above mentioned law the amount of aaid contributione (tauea), together with
pensltiea, interest, and costs that may aecrue in addition thereto, constitute s lien in favor of Florida
Induatrial Commisaion upon the title to and interes~ Mrhether legal or equitdble, in any real pmperty.
chattels resl. or personal property of aaid employer.
f
Periods for which contributiona. intereat, and penaltisa have been asaeased, and the amounta
~ tbereof, are as follows :
~
~wra~aT tM~ouoM
~RI00 CONTRI~{~TION~ ~NALTI[i
~d ~srter 1 Be1. 8 1
er 1 FA.EO AN 11
R£CORO VERI EO '
JAN •
R GE t
rotw~
WITNESS THE OFFICIAL SEAL OF THE FLOBIDA INDU3T~tIAL COMMISSION and the hand
oi the Chairman thereof, at Tallahaaaee, Florida, thia...l3~dsy of s+~~ , A. D. 1967
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. ~ ~ . C sirmanT. W. ~701~IISt011
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` I+ Flo -+a Ir ostrlal Commision
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- •.•••.SS•,,..: aooK164 ~109z
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